Musculoskeletal factsheets
Leading cause of premature mortality in Australia fact sheet:
Coronary heart disease
Coronary heart disease
What is coronary heart disease?
Quick facts
Coronary heart disease (CHD), also known as ischaemic heart
disease, is the most common form of cardiovascular disease
in Australia. CHD is due to blockages in the heart’s own
(coronary) arteries and presents as a heart attack (or acute
myocardial infarction), angina or sudden death (AIHW 2015a).
Coronary heart disease was the leading (1st)
cause of premature death in Australia in
2010–2012.
The primary cause of CHD—atherosclerosis—is a slow
build-up of fatty deposits in the coronary arteries which
reduces the flow of blood to the heart (National Heart
Foundation of Australia 2015).
Premature mortality refers to deaths that occur at a younger
age than a selected cut-off. For this analysis, deaths among
people under the age of 75 are considered premature.
Who dies prematurely from coronary heart
disease?
In 2012, there were 4,825 premature deaths due to CHD in
Australia. This makes CHD the biggest killer of Australians
under the age of 75. More than 3 times as many males
as females died prematurely from CHD (3,773 and 1,052
deaths, respectively) (Figure 1).
Premature deaths from CHD increased with age. Between the
ages of 50–54 and 70–74, the age-standardised mortality rate
increased sixfold—from 28 deaths per 100,000 population
to 179 deaths per 100,000. There were relatively few deaths
among people under the age of 40.
Age group (years)
1
More than 3 in 4 premature deaths
due to coronary heart disease in 2012
were among males (78%).
The premature death rate due to coronary
heart disease decreased by 85% over the
3 decades from 1982 to 2012.
85%
What population-level approaches target
premature deaths due to coronary heart
disease?
Both individual and population-level interventions can
modify an individual’s risk of CHD. ‘Modifiable’ risk factors—
which health practitioners and individuals can take action to
address—include:
• smoking (active smoking and exposure to second-hand
smoke)
• high blood cholesterol
• high blood pressure (also known as hypertension)
• diabetes
• physical inactivity
• being overweight
• depression, social isolation and a lack of social support
(National Heart Foundation of Australia 2015).
Monitoring even moderate risk factors in the wider
population helps to identify people who may benefit from
preventive interventions (AIHW 2015a).
Mortality from cardiovascular diseases, including CHD,
can be reduced by detection and management of high
blood pressure and high blood cholesterol levels through
lifestyle changes, medication and long-term management
(National Heart Foundation 2010).
Figure 1: Premature deaths due to coronary heart
disease, by sex and age group, 2012
A range of programs and initiatives support prevention,
optimal detection and treatment of CHD in developed
countries like Australia (Department of Health 2015);
Leading cause of premature mortality in Australia fact sheet: Coronary heart disease
however some risk factors which can be targeted at the
population-level, such as obesity, continue to grow here
and internationally (Fuster & Kelly 2010). Broader social
and environmental factors mean that individual behaviour
change is difficult and many people do not have the
resources to seek appropriate health care. There has been
improvement in some risk factors, for example through
the delivery of clinical prevention in high-risk patients and
reductions in smoking (Fuster & Kelly 2010).
Strategies controlling tobacco use and exposure to
second-hand smoke are some of the most well-developed
areas of policy targeting cardiovascular health, and are
supported by strong evidence (Fuster & Kelly 2010).
Australia is a signatory of the WHO Framework Convention
on Tobacco Control which focuses on both demand
reduction and supply control including taxation, health
warnings on tobacco products, advertising controls and quit
smoking services (WHO 2008).
Premature deaths due to coronary heart disease are
classified as ‘potentially avoidable in the context of the
present health system’ according to nationally agreed
definitions (AIHW 2015b). The definition includes deaths
from conditions that are potentially preventable through
individualised care and/or treatable through existing
primary or hospital care.
How have premature death rates due to
coronary heart disease changed over time?
Historically, premature mortality from CHD has been
consistently higher among males (Figure 2). Both males and
females have experienced substantial declines in CHD death
rates over the past 4 decades.
Deaths per 100,000
Deaths per 100,000
300
Males
Females
The age-standardised rate for males peaked at 315 deaths
per 100,000 population in 1968 and fell to 32 deaths per
100,000 in 2012—a 90% decrease. The age-standardised
rate for females declined from a peak of 120 in 1970 to
8.8 deaths per 100,000 in 2012—a 93% decrease.
While there have been decreases in the age-standardised
premature mortality rate among both sexes, the rate ratio
between the sexes has increased. Between 1992 and 2012
the age-standardised rate ratio increased from 2.7 to 3.6.
In other words, males were still 3.6 times as likely as
females to die prematurely from CHD in 2012.
While the overall downward trend in CHD death rates has
occurred in each age group, the rate of decline for both
males and females aged between 40 and 69 has slowed
in the decade to 2011 (AIHW 2014).
What has influenced trends in premature
deaths due to coronary heart disease?
Both prevention and treatment (including medical and
surgical) methods have contributed to the decrease in
premature deaths from CHD. There have been marked
increases in the use of statins to treat high cholesterol and
of anti-hypertensive medications to treat high blood
pressure (Briffa et al. 2009), as well as improvements in the
rates of smoking, high blood pressure and other risk factors
(Taylor et al. 2006).
For people with established CHD, significant reductions in
coronary events and deaths have been achieved through
revascularisation procedures that restore good blood supply
to the heart by either reducing or bypassing coronary artery
blockages. Better emergency care has also contributed to
improved premature mortality rates (AIHW 2014).
Where can I find out more?
200
Premature mortality in Australia (including references):
<http://www.aihw.gov.au/deaths/premature-mortality/>.
100
AIHW GRIM books:
<http://www.aihw.gov.au/deaths/grim-books/>.
0
1940 1950 1960 1970 1980 1990 2000 2010
AIHW web pages and publications:
<http://www.aihw.gov.au/cardiovascular-disease/>.
Figure 2: Age-standardised rate of premature deaths
due to coronary heart disease, by sex, 1940–2012
© Australian Institute of Health and Welfare 2015
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Suggested citation
Australian Institute of Health and Welfare 2015. Leading cause of
premature mortality in Australia fact sheet: coronary heart disease.
Cat. no. PHE 191. Canberra: AIHW.
ISBN 978-1-74249-791-4 (PDF)
Any enquiries about copyright and/or this fact sheet should be directed
to the Head of the Digital and Media Communications Unit, Australian
Institute of Health and Welfare, GPO Box 570, Canberra ACT 2601,
Tel: (02) 6244 1000, Email: <info@aihw.gov.au>.